March 28, 2025
A recent report in the MMWR1 describes a mother and her four children in New York who had elevated blood lead levels. After an environmental assessment, the only exposure was the surma that had been personally brought to the United States (US). One surma sample was available and was tested. It was found to have 390,000 ppm of lead. Surma is derived from an ore and is ground into a powder to use as an eye cosmetic and for cultural practices. Given its powdered form, there is increased risk for hand contamination which may result in hand to mouth exposure.
A recent study in Pediatrics2 from the New York Department of Health and Mental Hygiene noted that certain immigrant communities continued to have higher rates of blood lead levels compared to the rates in the city. During these investigations between the years 2013-2022, various samples of household products were obtained and tested. Of 220 samples, 37% were identified as surma-all of which had detectable levels of lead. Surma had the highest concentration of lead for all the products. The median lead concentration in 81 samples of surma was 730000 ppm with a maximum of 980000 ppm. A similar median level of lead was found in the 11 samples of kohl. Interestingly, while the sale of these products is banned in the US, this study reported that of all the traditional eye cosmetics and cultural powders that were studied, 46% were reportedly purchased in the US.
These recent studies serve as a reminder that sources of lead exposure can be from products other than lead paint, including traditional eye cosmetics.
Saralyn R. Williams, MD, Professor of Emergency Medicine, Medicine, and Pediatrics
- Hore P, Sedlar S. Ehrligh J. Lead poisoning in a mother and her four children using a traditional eye cosmetic-New York City, 2012-2023. MMWR 2024; 73:667-71.
- Hore P, Sedlar S. Traditional eye cosmetics and cultural powders as a source of lead exposure. Pediatrics 2024; 154(Suppl2):e2024067808O
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